A white soldier aged 29 was admitted to the hospital complaining of excruciating substernal pain radiating to both arms. He had been well until approximately one hour before admission to the ward, when, while walking at a normal gait, he was suddenly seized with a viselike pain centered at the top of the sternum radiating down the sternum and into both arms. He experienced severe vertigo and almost collapsed. He was immediately nauseated and vomited several times. Moderate dyspnea and diaphoresis were present. In spite of these symptoms he was able to walk to the admitting office of the hospital, not more than 100 yards away, where he was seen by the officer of the day and admitted to the medical service.

The past history revealed nothing of significance. It should be noted that the patient had been an active athlete, having pitched soft ball professionally and semiprofessionally during the